Background and Objectives: This study conducted a comprehensive bibliometric analysis of articles published in the Journal of Rhinology (JR), the official journal of the Korean Rhinologic Society, to examine research trends, thematic evolution, and emerging hotspots in rhinology. Methods: A total of 836 JR articles (1994–2025) were retrieved from PubMed and Research Information Sharing Service (RISS) after duplicate removal. The R bibliometrix package was used to perform keyword trend and thematic evolution analyses. VOSviewer was used to visualize keyword co-occurrence networks and temporal relationships between keywords. Gephi was used to calculate centrality measures, providing insight into the structural characteristics of the research network. Results: From 1994 to 2025, JR published an average of 26.6 articles per year, with publication activity increasing in recent years. Keyword and thematic analyses demonstrated that the research focus gradually shifted from basic disease- and anatomy-related topics and traditional clinical themes in the 2010s to functional conditions, infectious diseases, and increasingly surgical, procedural, and methodological research after 2020, while “rhinitis” and “sleep apnea syndromes” were consistently addressed. Co-occurrence analysis further identified “endoscopy” as a central keyword, highlighting its continued importance in JR research. Conclusion The articles published in JR encompass a broad spectrum of rhinology research, integrating disease pathophysiology, clinical applications, surgical techniques, and evidence-based approaches. These findings highlight evolving research trends and provide guidance for future domestic and international studies in rhinology.

Myofibromas are rare mesenchymal neoplasms that primarily affect infants and young children, most commonly arising in the skin, subcutaneous tissue, muscle, or bone. These tumors present with a broad clinical spectrum, ranging from self-limiting lesions to disseminated and fatal cases. In adults, the solitary form is encountered more frequently than the multicentric type. Although myofibromas may occur in the oral region of the head and neck, isolated cases involving the nasal septum are exceedingly rare. Here, we describe a case of solitary adult-onset myofibroma of the nasal septum that was successfully excised through transnasal endoscopic surgery.

Postoperative epistaxis is the most common complication after endoscopic sinus surgery (ESS) and septoplasty; however, it is usually immediate and self-limited. Delayed, severe hemorrhage is rare and should prompt evaluation for systemic causes. We report a rare case of acute immune thrombocytopenia (ITP) presenting as delayed, severe epistaxis after routine nasal surgery. A 46-year-old man with no history of bleeding disorders and normal coagulation profiles and platelet counts underwent ESS and revision septoplasty. On postoperative day 5, he presented with massive epistaxis and hypovolemic shock. Laboratory evaluation demonstrated severe isolated thrombocytopenia, with a platelet count of 5×103/μL. He was treated successfully with intravenous immunoglobulin and high-dose corticosteroids, which resulted in platelet recovery and cessation of bleeding. Although uncommon, surgical stress may act as a precipitating trigger for ITP, and this diagnosis should be included in the differential diagnosis of delayed, massive postoperative hemorrhage after routine nasal surgery.

A sinus mucocele is a dilated, epithelial-lined cystic lesion containing encapsulated mucus. Although its etiology remains uncertain, secondary infection may transform it into a pyocele. A 68-year-old female presented with sudden-onset ophthalmoplegia, ptosis, and blurred vision during the acute phase of COVID-19 infection. Physical examination and imaging identified an ethmoid sinus mucocele causing significant orbital compression. The patient underwent urgent endoscopic marsupialization. Intraoperative findings revealed increased internal pressure within the mucocele. Postoperatively, her ocular motility and ptosis improved immediately, with a full recovery of visual acuity within two weeks. This case suggests that COVID-19-associated mucosal inflammation or immune dysregulation may lead to the rapid expansion of pre-existing asymptomatic mucoceles. Clinicians should consider mechanical sinus lesions in the differential diagnosis of acute cranial nerve palsies during COVID-19 infection to ensure timely surgical decompression.

The two main categories of benign fibro-osseous lesions are ossifying fibroma and fibrous dysplasia. Both entities occur infrequently in the sinonasal tract. Fibro-osseous lesions involving the nasal turbinates, in particular, are extremely rare. A 19-year-old woman presented with chronic nasal obstruction and purulent rhinorrhea and was diagnosed with fibrous dysplasia involving the inferior turbinate. A 16-year-old boy presented with similar symptoms and was diagnosed with ossifying fibroma involving the middle turbinate. Both patients underwent endoscopic endonasal resection. Postoperatively, symptoms improved, and no recurrence was observed during followup. These cases highlight the rarity of turbinate involvement and suggest that endoscopic endonasal surgery is an effective treatment option.

Chronic invasive fungal rhinosinusitis (CIFR) is a rare subtype of invasive fungal rhinosinusitis characterized by a slow clinical course and histopathologic evidence of tissue invasion. It is distinct from noninvasive fungal ball rhinosinusitis and acute invasive fungal rhinosinusitis. The standard treatment for CIFR consists of surgical debridement combined with systemic antifungal therapy. However, systemic antifungal agents may not be feasible in certain patients because of drug-related toxicity, impaired renal function, or socioeconomic constraints. In addition, the optimal role of topical antifungal therapy in CIFR has not been clearly established. Herein, we describe two patients with diabetes mellitus who had CIFR confined to the sinonasal cavity and were managed with surgical debridement combined with topical amphotericin B application, without systemic antifungal therapy. Both patients demonstrated favorable clinical outcomes. These cases suggest that, in carefully selected patients with localized CIFR, a surgery-centered management strategy incorporating adjunctive topical amphotericin B may represent a feasible alternative when systemic antifungal therapy cannot be administered, provided that careful and prolonged follow-up is ensured.

Background and Objectives: Differentiating inverted papilloma (IP) from squamous cell carcinoma arising in IP (IP+SCC) is challenging when computed tomography (CT) demonstrates no bone destruction. This study aimed to identify CT and magnetic resonance imaging (MRI) features that distinguish IP from IP+SCC in cases without bone destruction on CT. Methods: We retrospectively reviewed 30 patients with histologically confirmed sinonasal IP (n=15) or IP+SCC (n=15) who underwent preoperative CT and MRI between 2010 and 2023. Imaging variables assessed included tumor origin, tumor volume, CT enhancement pattern, signal intensity on T2-weighted and contrast-enhanced T1-weighted images, apparent diffusion coefficient (ADC), and the presence or loss of the convoluted cerebriform pattern (CCP). Group differences were analyzed using appropriate statistical tests, with p<0.05 considered statistically significant. Results: There was no statistically significant difference in tumor origin between the IP and IP+SCC groups. Tumor volume and CT enhancement patterns also did not differ significantly between the groups. On MRI, IP+SCC more frequently demonstrated intermediate signal intensity on both T2-weighted and contrast-enhanced T1-weighted images compared with IP (p=0.025 and p=0.029, respectively). Median ADC values were significantly lower in the IP+SCC group than in the IP group (0.99×10-3 vs. 1.20×10-3 mm2/s; p=0.026). Loss of the CCP was more common in the IP+SCC group, although the difference did not reach statistical significance. Conclusion In sinonasal IP without bone destruction on CT, MRI appears to be more informative than CT for distinguishing IP+SCC from IP. Intermediate signal intensity on T2-weighted and contrast-enhanced T1-weighted images, along with lower ADC values, supports malignant transformation, whereas tumor size, CT enhancement, and CCP alone are less reliable discriminators.

Background and Objectives: Glomangiopericytoma (GPC) is a rare, low-grade mesenchymal neoplasm that most commonly arises in the nasal cavity and paranasal sinuses. Its rarity, together with overlapping histopathological features shared with other spindle-cell tumors, makes diagnosis challenging, and available data regarding its clinical behavior and optimal management remain limited. This study aimed to present a retrospective case series of GPC from a tertiary referral center, with particular emphasis on clinical presentation, diagnostic evaluation, histopathological characteristics, surgical management, and outcomes. Methods: Following institutional ethics approval, we conducted a retrospective review of patients treated for GPC between January 2010 and August 2025 at a tertiary care center. Collected data included demographic characteristics, clinical presentation, imaging findings, histopathological features with immunohistochemistry, surgical management, and follow-up outcomes. Results: Eleven patients (six women and five men; mean age, 70.9 years) were included. The most common presenting symptoms were unilateral nasal obstruction, rhinorrhea, headache, and recurrent epistaxis. Tumors predominantly involved the nasal cavity—particularly the posterior septum, sphenoethmoidal recess, and middle turbinate—as well as the ethmoid sinus. Four cases demonstrated locoregional extension, and two required skull base reconstruction. Tumor diameter ranged from 0.8 to 4.0 cm. All patients underwent endoscopic endonasal resection. No recurrences were observed during follow-up, which ranged from 1 month to 15 years (mean, 3.54 years); however, these findings should be interpreted cautiously given the variability in follow-up duration. Immunohistochemistry consistently demonstrated nuclear β-catenin positivity and negative STAT6 expression. Conclusion GPC is a rare and distinct vascular neoplasm characterized by perivascular spindle-cell proliferation and nuclear β-catenin expression. Endoscopic resection was the primary treatment modality in our cohort, and long-term surveillance remains essential because of the potential for delayed recurrence. This case series provides a descriptive overview of the clinical features, diagnostic approaches, and management of GPC.

Chronic rhinosinusitis (CRS) is increasingly recognized as a heterogeneous disease with distinct inflammatory endotypes, among which eosinophilic CRS (ECRS)—a category that substantially overlaps with, but is not equivalent to, Type 2 CRS—is associated with severe symptoms, frequent recurrence, and comorbid asthma. Accurate identification of Type 2 CRS has become clinically essential with the emergence of biologic therapies that target Type 2 inflammatory pathways. However, most diagnostic criteria, including those proposed by European Position Paper on Rhinosinusitis and Nasal Polyps 2020 (EPOS 2020), were developed from Western populations, in which ECRS with nasal polyps predominates. This review critically examines the applicability of these criteria in Asian populations, in which non-eosinophilic and mixed inflammatory endotypes remain prevalent. Evidence from Korean and Japanese cohorts indicates that the EPOS 2020 Type 2 criteria have poor specificity in Asian patients with CRS with nasal polyps, classifying nearly all such patients as Type 2 because of differences in baseline biomarker distributions. We discuss histological thresholds for defining ECRS and highlight that Asian studies support higher tissue eosinophil cut-offs, approximately 70 eosinophils per high-power field (HPF) or around 10% of total inflammatory cells, compared with the 10 eosinophils per HPF recommended by Western guidelines. This review also evaluates outpatient- friendly scoring systems, such as Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) and newly proposed Korean diagnostic criteria, as well as emerging machine-learning approaches for noninvasive prediction of ECRS. We conclude that clinicians in Asia should adopt regionally validated criteria that integrate histological, serological, and clinical parameters to accurately identify Type 2 CRS, optimize selection of biologic candidates, and improve prognostic counseling in this population.

Background and Objectives: A substantial proportion of patients presenting with sinus headaches are ultimately diagnosed with migraines. The ID-Migraine tool has been developed to aid in identifying migraine patients in primary care settings. Therefore, we conducted a meta-analysis of validation studies evaluating the diagnostic accuracy of the ID-Migraine tool. Methods: Data were extracted regarding true positives, false positives, true negatives, and false negatives, along with study characteristics. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Results: In total, 30 studies involving 9,942 participants were included in the final analysis. The pooled diagnostic odds ratio for the ID-Migraine tool was 13.84. The area under the summary receiver operating characteristic curve was 0.846. The pooled sensitivity and specificity were 0.865 and 0.702, respectively, while the negative predictive value was 0.791 and the positive predictive value was 0.799. Conclusion The ID-Migraine screening tool is highly accurate and user-friendly for identifying migraines among patients presenting with sinus headaches. By employing this tool, unnecessary diagnostic tests or treatments can be minimized, and patients can be promptly referred to appropriate specialists.